Humanizing Patients and Physicians Through Storytelling By Eniola Gros, MS4 and Al’ai Alvarez, MD, APD on behalf of the Academy for Diversity and Inclusion in Emergency Medicine
RACISM AS A PUBLIC HEALTH CRISIS
The Story…
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In one of the most racially segregated cities in America, I sat in the clinic conference room going over flashcards for my next shelf exam. It was hot and I couldn't hear myself think over the loud blower fan in the corner. Had I arrived at five o’clock that morning, I would have seen a line of patients waiting anxiously outside, hoping that their spot in line would allow them to be seen by a doctor. There were babies crying in the stuffy waiting room, mothers and fathers taking advantage of their only opportunity that week to charge their phones, and patients randomly checking boxes on their triage forms because they don’t know how to read the questionnaires. Saint Louis is one of the many cities in this country that still experiences the wrath of de jure segregation. In 1916, the City of Saint Louis established a racial segregation ordinance mandating 75 percent of residents within any given
“We are people responding to a calling. All of us can be part of the effort. We are brothers and sisters in medicine.” neighborhood be of the same race. Given the already segregated parks, hospitals, and universities, the city needed to find a suitable dividing line to establish this law. That dividing line is Delmar Boulevard. Despite deeming this ordinance unconstitutional in the late 1940s, its effects remain today. Just by crossing the “Delmar Divide” traveling north-bound, your life expectancy decreases by six years and your overall health rating (rated from low to highrisk), as determined by demographics, socioeconomic status and access to quality health care, increases four-fold.
The free student-run clinic at my school serves more than 2,000 patients that fall into this bracket. We serve single mothers and patients who are either without a home or with prior convictions — all working-class citizens without health insurance. As I listened to the preclinical student’s patient presentation, I wasn’t surprised that it was different from my history and physical exam findings. Before I saw the patient, my junior student informed me that “the patient is a poor historian.” Hearing a commotion on the other side of the door, I opened
